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Lancet (London, England) Aug 2023Cutaneous melanoma is a malignancy arising from melanocytes of the skin. Incidence rates are rising, particularly in White populations. Cutaneous melanoma is typically... (Review)
Review
Cutaneous melanoma is a malignancy arising from melanocytes of the skin. Incidence rates are rising, particularly in White populations. Cutaneous melanoma is typically driven by exposure to ultraviolet radiation from natural sunlight and indoor tanning, although there are several subtypes that are not related to ultraviolet radiation exposure. Primary melanomas are often darkly pigmented, but can be amelanotic, with diagnosis based on a combination of clinical and histopathological findings. Primary melanoma is treated with wide excision, with margins determined by tumour thickness. Further treatment depends on the disease stage (following histopathological examination and, where appropriate, sentinel lymph node biopsy) and can include surgery, checkpoint immunotherapy, targeted therapy, or radiotherapy. Systemic drug therapies are recommended as an adjunct to surgery in patients with resectable locoregional metastases and are the mainstay of treatment in advanced melanoma. Management of advanced melanoma is complex, particularly in those with cerebral metastasis. Multidisciplinary care is essential. Systemic drug therapies, particularly immune checkpoint inhibitors, have substantially increased melanoma survival following a series of landmark approvals from 2011 onward.
Topics: Humans; Melanoma; Skin Neoplasms; Ultraviolet Rays; Sentinel Lymph Node Biopsy; Lymph Node Excision; Melanoma, Cutaneous Malignant
PubMed: 37499671
DOI: 10.1016/S0140-6736(23)00821-8 -
Veterinary Sciences Apr 2022Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize... (Review)
Review
Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize to lymph nodes and internal organs. This review focuses on the diagnosis and prognosis of canine melanocytic neoplasms. While pigmented melanocytic neoplasms can be diagnosed with fine-needle aspirates, an accurate prognosis requires surgical biopsy. However, differentiating amelanotic spindloid melanomas from soft tissue sarcomas is challenging and often requires immunohistochemical labeling with a diagnostic cocktail that contains antibodies against Melan-A, PNL-2, TRP-1, and TRP-2 as the current gold standard. For questionable cases, RNA expression analysis for TYR, CD34, and CALD can further differentiate these two entities. The diagnosis of amelanotic melanomas will be aided by submitting overlying and/or lateral flanking epithelium to identify junctional activity. Wide excision of lateral flanking epithelium is essential, as lentiginous spread is common for malignant mucosal melanomas. Combining histologic features (nuclear atypia, mitotic count, degree of pigmentation, level of infiltration, vascular invasion; tumor thickness and ulceration) with the Ki67 index provides the most detailed prognostic assessment. Sentinel lymph nodes should be evaluated in cases of suspected malignant melanomas using serial sectioning of the node combined with immunohistochemical labeling for Melan-A and PNL-2.
PubMed: 35448673
DOI: 10.3390/vetsci9040175 -
Melanoma Research Jun 2019Cutaneous amelanotic melanoma (AM) is a rare amelanotic or a hypomelanotic subtype of melanoma, comprising only 0.4-27.5% of all melanoma cases. The mean age of the... (Review)
Review
Cutaneous amelanotic melanoma (AM) is a rare amelanotic or a hypomelanotic subtype of melanoma, comprising only 0.4-27.5% of all melanoma cases. The mean age of the patients is over 50 years, and the male/female ratio varies from 0.5 to 4. Patients with red hair, type I skin, freckles, lack of nevi on the back, a sun-sensitive phenotype, or previous AM history are more likely to develop AMs. As AMs lack pigmentation, their appearances vary and can mimic many benign and malignant conditions, thus presenting a diagnostic challenge. AMs are composed of greater proportions of nodular melanoma, acral lentiginous melanoma, and desmoplastic melanoma than pigmented melanomas. They also present with thicker Breslow thickness, higher mitotic rate, more frequent ulceration, higher tumor stage, and lower survival than pigmented melanomas.
Topics: Humans; Melanoma, Amelanotic; Prognosis
PubMed: 30672881
DOI: 10.1097/CMR.0000000000000571 -
BMJ (Clinical Research Ed.) Mar 2018
Topics: Diagnostic Errors; Female; Fingers; Humans; Melanoma, Amelanotic; Middle Aged; Skin; Skin Neoplasms
PubMed: 29545447
DOI: 10.1136/bmj.k826 -
Acta Medica Portuguesa Jun 2021
Topics: Diagnosis, Differential; Humans; Melanoma, Amelanotic; Skin Neoplasms
PubMed: 33861192
DOI: 10.20344/amp.13044 -
Ugeskrift For Laeger Jul 2021Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can...
Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can occur in all age groups and affect both men and women. Although pyogenic granuloma is a benign lesion, differential diagnosis may include malignant tumours such as amelanotic melanoma, basal cell carcinoma and spindle cell tumour. Surgical excision with primary closure is the usual treatment for pyogenic granuloma/lobular capillary haemangioma and has the lowest rate of recurrence.
Topics: Diagnosis, Differential; Female; Granuloma, Pyogenic; Humans; Male; Melanoma; Neoplasm Recurrence, Local; Skin Neoplasms
PubMed: 34356018
DOI: No ID Found -
Journal of the European Academy of... Oct 2017Paediatric melanoma, although rare, is the most common skin cancer in children. Our current knowledge on paediatric melanoma incidence trends is expanding, as several... (Review)
Review
Paediatric melanoma, although rare, is the most common skin cancer in children. Our current knowledge on paediatric melanoma incidence trends is expanding, as several studies have addressed this issue with conflicting results. Known risk factors for paediatric melanoma include family history of melanoma, a previous history of malignancy, large congenital nevi, numerous melanocytic nevi, sunburns, increased UV exposure and a sun-sensitive phenotype. In younger children, melanoma more often presents with atypical features, such as a changing, amelanotic or uniformly coloured, often bleeding lesion, not fulfilling in most cases the conventional ABCDE criteria. The major differential diagnoses are melanocytic nevi, proliferative nodules in congenital nevi and atypical Spitz tumours. Moreover, in the younger age group non-Caucasian children are over-represented, tumours tend to be thicker and lymph nodes are often involved. Despite the frequent diagnosis at an advanced stage, the overall survival is fair in paediatric melanoma. Specific guidelines for management of melanoma in children do not exist, and most often the disease is treated similarly to melanoma in adults.
Topics: Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Melanoma; Risk Factors; Young Adult
PubMed: 28449284
DOI: 10.1111/jdv.14299 -
Current Opinion in Pediatrics Aug 2020To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence. (Review)
Review
PURPOSE OF REVIEW
To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence.
RECENT FINDINGS
The incidence of melanoma in pediatric patients has been declining in the past decades. Pediatric-specific diagnostic criteria should be utilized when assessing lesions concerning for melanoma to better account for the different presentations seen in pediatric disease compared with adults, such as an increased prevalence of amelanotic melanoma or frequent mimic of benign pediatric lesions. Pediatric melanoma often presents with a higher histopathologic stage and a higher Breslow depth as compared with adult melanoma. Pediatric nonmelanoma skin cancer including basal cell carcinoma and squamous cell carcinoma are associated with genetic conditions and immunosuppression, both iatrogenic and inherited.
SUMMARY
Melanoma in pediatric patients often presents differently from conventional adult melanoma, including Spitz melanoma and melanoma associated with congenital melanocytic nevi. Pediatric patients with nonmelanoma skin cancers should be evaluated for predisposing risk factors. More research on therapeutic options for pediatric skin cancer is vital to understanding the tolerance and response of our pediatric patients to therapies that are more frequently utilized in adult disease.
Topics: Adolescent; Adult; Carcinoma, Basal Cell; Child; Humans; Melanoma; Nevus, Pigmented; Skin; Skin Neoplasms
PubMed: 32618791
DOI: 10.1097/MOP.0000000000000917 -
Ugeskrift For Laeger Apr 2023In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin...
In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin was examined without any suspicious moles. A PET-CT scan showed an area on the left heel with increased activity. The element surprisingly showed an amelanotic melanoma. Amelanotic melanomas have a significantly worse prognosis compared to pigmented melanomas, presumably because they are detected later and may be very difficult to detect clinically. This case shows the importance of paying attention to unpigmented elements when searching for a primary tumour.
Topics: Female; Humans; Middle Aged; Melanoma, Amelanotic; Positron Emission Tomography Computed Tomography; Skin Neoplasms; Prognosis; Diagnosis, Differential
PubMed: 37114579
DOI: No ID Found -
GE Portuguese Journal of... Sep 2021
PubMed: 34604472
DOI: 10.1159/000512090